DirectionsThis form is to be used for faculty and staff only.Network Services does not create network ID accounts for student workers.

The department Supervisor, Chairperson or Dean will need to complete this form and submit it to Network Services before a network ID account can be created for any new or current employee. Please provide the requested information as accurately as possible. Many fields are required in order to ensure that the information is accurate and valid. Once the account is created, Network Services will send, via e-mail, account information to the requestor.

Please allow 1 – 3 days for the request to be verified and fulfilled.

NOTE: Fields marked with an asterisk (*) are required.

* Date of request:

Section 1 - Management Information

*Manager's Name:

*Manager's Department:

*Manager's Phone:

Section 2 - New/ Current User Information

*First Name:
Middle Name or Initial:
*Last Name:

*Title:

*Department:

*Building:

*Office Number:

*Phone:

Employment Status:

Faculty
Staff

Full Time
Part Time

Section 3 - Other Information

*Date User Will Begin Work:

Will the user need access to a network printer?
Yes
No

If yes, where is the printer located (building/office)?

Will the user use a PC or Mac?
PC
Mac

Is the new employee replacing another employee?
Yes
No

If yes, can the old user account be deleted? (This will permanently remove the user from our system, including e-mail, network storage, etc.)
Yes
No

Former Employee's Name:

Notes:

When you have completed this form, you can submit your request by clicking the Submit button below.